The purpose of this meta-analysis was to provide clinical evidence regarding relationship between ADC and cellularity in different tumors based on large patient data. Medline library was screened for ...associations between ADC and cell count in different tumors up to September 2016. Only publications in English were extracted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) was used for the research. Overall, 39 publications with 1530 patients were included into the analysis. The following data were extracted from the literature: authors, year of publication, number of patients, tumor type, and correlation coefficients. The pooled correlation coefficient for all studies was ρ = -0.56 (95 % CI = -0.62; -0.50),. Correlation coefficients ranged from
=-0.25 (95 % CI = -0.63; 0.12) in lymphoma to ρ=-0.66 (95 % CI = -0.85; -0.47) in glioma. Other coefficients were as follows: ovarian cancer, ρ = -0.64 (95% CI = -0.76; -0.52); lung cancer, ρ = -0.63 (95 % CI = -0.78; -0.48); uterine cervical cancer, ρ = -0.57 (95 % CI = -0.80; -0.34); prostatic cancer, ρ = -0.56 (95 % CI = -0.69; -0.42); renal cell carcinoma, ρ = -0.53 (95 % CI = -0.93; -0.13); head and neck squamous cell carcinoma, ρ = -0.53 (95 % CI = -0.74; -0.32); breast cancer, ρ = -0.48 (95 % CI = -0.74; -0.23); and meningioma,
= -0.45 (95 % CI = -0.73; -0.17).
The purpose of the present meta-analysis was to provide evident data about use of Apparent Diffusion Coefficient (ADC) values for distinguishing malignant and benign breast lesions.
MEDLINE library ...and SCOPUS database were screened for associations between ADC and malignancy/benignancy of breast lesions up to December 2018. Overall, 123 items were identified. The following data were extracted from the literature: authors, year of publication, study design, number of patients/lesions, lesion type, mean value and standard deviation of ADC, measure method, b values, and Tesla strength. The methodological quality of the 123 studies was checked according to the QUADAS-2 instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without any further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malign lesions.
The acquired 123 studies comprised 13,847 breast lesions. Malignant lesions were diagnosed in 10,622 cases (76.7%) and benign lesions in 3225 cases (23.3%). The mean ADC value of the malignant lesions was 1.03 × 10
mm
/s and the mean value of the benign lesions was 1.5 × 10
mm
/s. The calculated ADC values of benign lesions were over the value of 1.00 × 10
mm
/s. This result was independent on Tesla strength, choice of b values, and measure methods (whole lesion measure vs estimation of ADC in a single area).
An ADC threshold of 1.00 × 10
mm
/s can be recommended for distinguishing breast cancers from benign lesions.
Diffusion weighted imaging (DWI) is a magnetic resonance imaging (MRI) technique based on measure of water diffusion in tissues. This diffusion can be quantified by apparent diffusion coefficient ...(ADC). Some reports indicated that ADC can reflect tumor proliferation potential. The purpose of this meta-analysis was to provide evident data regarding associations between ADC and KI 67 in different tumors. Studies investigating the relationship between ADC and KI 67 in different tumors were identified. MEDLINE library was screened for associations between ADC and KI 67 in different tumors up to April 2017. Overall, 42 studies with 2026 patients were identified. The following data were extracted from the literature: authors, year of publication, number of patients, tumor type, and correlation coefficients. Associations between ADC and KI 67 were analyzed by Spearman's correlation coefficient. The reported Pearson correlation coefficients in some studies were converted into Spearman correlation coefficients. The pooled correlation coefficient between ADCmean and KI 67 for all included tumors was ρ = -0.44. Furthermore, correlation coefficient for every tumor entity was calculated. The calculated correlation coefficients were as follows: ovarian cancer: ρ = -0.62, urothelial carcinomas: ρ = -0.56, cerebral lymphoma: ρ = -0.55, neuroendocrine tumors: ρ = -0.52, glioma: ρ = -0.51, lung cancer: ρ = -0.50, prostatic cancer: ρ = -0.43, rectal cancer: ρ = -0.42, pituitary adenoma:ρ = -0.44, meningioma, ρ = -0.43, hepatocellular carcinoma: ρ = -0.37, breast cancer: ρ = -0.22.
The concept of frailty offers a convenient way to introduce unobserved heterogeneity and associations into models for survival data. In its simplest form, frailty is an unobserved random ...proportionality factor that modifies the hazard function of an individual or a group of related individuals. Frailty Models in Survival Analysis presents a compreh
Background:
The purpose of this meta-analysis was to analyze the influence of sarcopenia, defined as low skeletal muscle mass, on clinical outcomes in patients with head and neck squamous cell ...carcinoma (HNSCC) based on a large sample.
Methods:
The MEDLINE, EMBASE, and SCOPUS databases were screened for associations between sarcopenia and clinical outcomes in HNSCC up to December 2020. Overall, 27 studies met the inclusion criteria. The methodological quality of the studies involved was checked according to the QUADAS instrument. The meta-analysis was undertaken using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used to account for heterogeneity between the studies.
Results:
The 27 included studies comprised 7704 patients with different HNSCCs. The cumulative calculated frequency among the studies was 42.0% 95% confidence interval (CI) 35.34–48.65. Sarcopenia was associated with occurrence of severe postoperative complications, odds ratio (OR) 4.79, 95% CI (2.52–9.11), p < 0.00001. Sarcopenia predicted disease-free survival (DFS), simple regression: hazard ratio (HR) 2.00, 95% CI (1.63–2.45), p < 0.00001, multiple regression: HR 1.64, 95% CI (1.33–2.03), p < 0.00001. Also, sarcopenia was associated with lower overall survival (OS), simple regression: HR 1.96, 95% CI (1.71–2.24), p < 0.00001, multiple regression: HR = 1.87, 95% CI (1.53–2.29), p < 0.00001. In patients who underwent definitive chemotherapy and/or radiation, sarcopenia predicted lower OS (simple regression), HR 1.95, 95% CI (1.61–2.36), p < 0.00001, multiple regression: HR = 1.51, 95% CI (1.17–1.94), p < 0.002). In patients with primary surgical strategy with or without adjuvant radio-chemotherapy, sarcopenia was associated with lower OS (simple regression), HR 2.21, 95% CI (1.72–2.84), p < 0.00001, multiple regression: HR = 2.05, 95% CI (1.55–2.72), p < 0.00001).
Conclusion:
The cumulative prevalence of sarcopenia in HNSCC is 42.0%. Sarcopenia is an independent risk factor for OS and DFS in patients with HNSCC who undergo curative therapy. Sarcopenia is associated with the occurrence of severe postoperative complications.
•First meta analysis regarding the associations between low skeletal muscle mass and mortality in critical ill patients.•LSMM is frequent in critical ill patients with 50.9%.•LSMM has a odds ratio of ...2.78 for short-term mortality.
Low skeletal muscle mass (LSMM) can be assessed by imaging modalities and is associated with several clinically relevant factors in critically ill patients. Our aim was to establish the effect of computed tomography (CT)–defined LSMM on short-term mortality in critically ill patients based on a large patient sample.
The MedLine library and the Cochrane and SCOPUS databases were screened for associations between CT-defined LSMM and short-term mortality in critically ill patients up to May 2021. The primary endpoint of the systematic review was the odds ratio of sarcopenia on mortality. In total, nine studies were selected as suitable for the analysis and included into the present analysis.
The studies included a total of 1563 critically ill patients with different underlying diagnoses. The pooled overall prevalence of LSMM was 50.9%. The pooled odds ratio for the effect of sarcopenia on short-term mortality was 2.78 (95% confidence interval, 2.05–3.75).
CT-defined LSMM is highly prevalent in critically ill patients, has a relevant effect on short-term mortality, and should be included as a relevant prognostic biomarker in clinical routines.
Fluorodeoxyglucose-Positron-emission tomography (FDG-PET), quantified by standardized uptake values (SUV), is one of the most used functional imaging modality in clinical routine. It is widely ...acknowledged to be strongly associated with Glucose-transporter family (GLUT)-expression in tumors, which mediates the glucose uptake into cells. The present systematic review sought to elucidate the association between GLUT 1 and 3 expression with SUV values in various tumors.
MEDLINE library was screened for associations between FDG-PET parameters and GLUT correlation cancer up to October 2018.
There were 53 studies comprising 2291 patients involving GLUT 1 expression and 11 studies comprising 405 patients of GLUT 3 expression. The pooled correlation coefficient for GLUT 1 was r = 0.46 (95% CI 0.40-0.52), for GLUT 3 was r = 0.35 (95%CI 0.24-0.46). Thereafter, subgroup analyses were performed. The highest correlation coefficient for GLUT 1 was found in pancreatic cancer r = 0.60 (95%CI 0.46-0.75), the lowest was identified in colorectal cancer with r = 0.21 (95% CI -0.57-0.09).
An overall only moderate association was found between GLUT 1 expression and SUV values derived from FDG-PET. The correlation coefficient with GLUT 3 was weaker. Presumably, the underlying mechanisms of glucose hypermetabolism in tumors are more complex and not solely depended on the GLUT expression.
Abstract Systemic sclerosis (SSc) is a multifaceted disease, and its diagnosis triggers substantial anxiety and uncertainty for those affected. Currently, there are no valid data describing the ...impact of disease-specific patient education on the disease knowledge available. We created a two-day, online educational seminar to provide SSc patients with disease-specific information. The primary objective of the study was to observe the change in the disease-specific knowledge of the patients. A total of 118 patients were randomized into an intervention group and a waiting list control group. The change in knowledge was assessed using a multiple-choice test. The intervention group completed the questionnaire before, directly after, and 3 months after the seminar, while the waiting list control group also took the test 3 months before the seminar to rule out nonspecific learning. The primary outcome measure was the score difference between baseline and 3 months after baseline. The study was registered in the German Clinical Trials Register (protocol code DRKS00024915). The educational seminar resulted in a small, but measurable, increase in knowledge. While the two tests in the waiting list control group prior to the seminar did not show a nonspecific increase in disease knowledge, the intervention led to a numerical increase in knowledge (mean ± sd score difference 0.34 ± 1.31, 95% CI (− 0.23; 0.86), p = 0.26) that did not reach statistical significance. Multiple linear regression analysis showed that being a member of a self-help group (β = 1.12; p = 0.03) is a positive predictor of a higher disease knowledge. Although highly appreciated by participants, a two-day online seminar may not be the most appropriate format to generate measurable disease-specific knowledge. Self-help group membership was a positive predictor of a higher level of disease-specific knowledge prior to the educational seminar and should be recommended to every affected person.
The purpose of the present meta-analysis was to provide evident data about use of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign lesions in the head and neck ...region.
MEDLINE and Scopus databases were screened for associations between ADC and malignancy/benignancy of head and neck lesions up to December 2018. Overall, 22 studies met the inclusion criteria. The following data were extracted: authors, year of publication, study design, number of patients/lesions, lesion type, mean value, and standard deviation of ADC. The primary endpoint of the systematic review was the analysis of the association between lesion nature and ADC values. The methodological quality of the involved studies was checked according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malignant lesions.
The acquired 22 studies comprised 1,227 lesions. Different malignant lesions were diagnosed in 818 cases (66.7%) and benign lesions in 409 cases (33.3%). The mean ADC value of the malignant lesions was 1.04 × 10
mm
/s, and the mean value of the benign lesions was 1.46 × 10
mm
/s. Lymphomas and sarcomas showed the lowest calculated mean ADC values, 0.7 and 0.79 × 10
mm
/s, respectively. Adenoid cystic carcinomas had the highest ADC values (1.5 × 10
mm
/s). None of the analyzed malignant tumors had mean ADC values above 1.75 × 10
mm
/s.
ADC values play a limited role in distinguishing between malignant and benign lesions in the head and neck region. It may be only suggested that lesions with mean ADC values above 1.75 × 10
mm
/s are probably benign. Further large studies are needed for the analysis of the role of diffusion-weighted imaging (DWI)/ADC in the discrimination of benign and malignant lesions in the head and neck region.
Magnetic resonance imaging is used to stage thyroid tumors. Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) can be used to reflect tumor microstructure. Our aim was to ...compare ADC values of malignant and benign thyroid lesions based on a large sample.
MEDLINE library, EMBASE and SCOPUS databases were screened for the associations between ADC values and thyroid lesions up to August 2021. The primary endpoint of the systematic review were ADC values of benign and malignant thyroid lesions. In total, 29 studies were suitable for the analysis and were included into the present study.
The included studies comprised a total of 2137 lesions, 1118 (52.3%) benign and 1019 (47.7%) malignant lesions. The pooled mean ADC value of the benign thyroid lesions was 1.88 × 10−3 mm2/s 95% CI 1.77–2.0 and the pooled mean ADC value of malignant thyroid lesions was 1.15 × 10−3 mm2/s 95% CI 1.04–1.25.
ADC can well discriminate benign and malignant thyroid tumors. Therefore, DWI should be implemented into the presurgical diagnostic work-up in clinical routine.
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